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The Scoop on Newborn Heart Murmurs: When to Worry and When to Breathe Easy

Posted on April 4, 2025April 3, 2025 By Kirsten Fisch

When a newborn enters the world, parents want everything to be perfect, including their baby’s health. A heart murmur is an unexpected finding that may arise during a newborn’s first examination. While the term “heart murmur” can sound alarming, it is essential to understand what it means and what to expect moving forward.

What is a Heart Murmur?

A heart murmur is an extra or unusual sound heard during a heartbeat. Usually, the heart makes a “lub-dub” sound as the valves open and close to circulate blood. A murmur is a whooshing or swishing sound due to turbulent blood flow within the heart or blood vessels near it. Murmurs are detected using a stethoscope and are categorized based on their characteristics and intensity.

Are Heart Murmurs in Newborns Normal?

Heart murmurs in newborns are common and do not always indicate a serious problem. Many murmurs are classified as “innocent” or “functional” murmurs, meaning they are harmless and usually disappear as the baby grows. Innocent murmurs often result from the normal development of the baby’s circulatory system and do not require treatment.

However, in some cases, a murmur may indicate an underlying heart condition, such as a congenital heart defect (CHD). These defects range from minor concerns that resolve independently to more complex conditions requiring medical intervention.

What Causes Heart Murmurs in Newborns?

Heart murmurs can be caused by various factors, including:

  • Regular physiological changes occur as the newborn’s circulatory system adapts to life outside the womb.
  • Congenital heart defects, such as a hole in the heart (septal defect) or abnormal heart valve function.
  • Persistent fetal circulation issues, where the baby’s circulatory system does not transition appropriately after birth.

What Happens if a Heart Murmur is Detected?

If a doctor hears a murmur during your newborn’s exam, they will assess the baby’s overall health, including breathing patterns, skin color, feeding habits, and growth. Depending on these factors, the doctor may:

  1. Reevaluate the baby later – Many innocent murmurs resolve within the first few weeks of life.
  2. Recommend additional tests – If the murmur raises concerns, further evaluation may include:
    • An echocardiogram (heart ultrasound) examines the heart’s structure and function.
    • An electrocardiogram (ECG) assesses the heart’s electrical activity.
    • Chest X-ray to evaluate heart size and lung circulation.
  3. Refer to a pediatric cardiologist – If a congenital heart defect is suspected, a specialist will determine the next steps for treatment and management.

Treatment and Prognosis

Most newborn murmurs require no treatment and resolve naturally. If a heart defect is diagnosed, management may include:

  • Observation – Some minor defects close on their own over time.
  • Medication – Certain conditions may benefit from medication to help regulate heart function.
  • Surgery or catheter-based procedures – Severe defects may require surgical intervention.

When Should Parents Be Concerned?

While many murmurs are benign, parents should seek medical attention if they notice the following symptoms:

  • Difficulty feeding or poor weight gain
  • Rapid breathing or difficulty breathing
  • Blue-tinted skin (cyanosis), especially around the lips or fingers
  • Lethargy or excessive sleepiness

Hearing that your newborn has a heart murmur can be unsettling, but in most cases, it is not a cause for alarm. Many murmurs are harmless and resolve on their own as the baby grows. However, following up with your pediatrician to ensure that concerns are appropriately evaluated is always essential. With appropriate monitoring and care, most babies with heart murmurs go on to live healthy, active lives.

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Kirsten Fisch

Kirsten Fisch, MSN, RNC-MNN, IBCLC, LCCE
Kirsten Fisch is a women's health nurse specializing in high-risk pregnancy and postpartum care. Certified in Maternal Newborn Nursing, a board-certified lactation consultant (IBCLC), and a Lamaze Certified Childbirth Educator, she works with women from conception through postpartum. Passionate about empowering women during their reproductive journeys, Kirsten combines evidence-based care with compassionate support to promote health and well-being for mothers and babies.

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